Cost and utility in immunocompromised subjects who developed herpes zoster during the randomized V212 Inactivated Varicella-Zoster Vaccine (ZV IN ) trial.

OBJECTIVES: Immunocompromised subjects are at increased risk for herpes zoster (HZ) and HZ-related complications, such as post herpetic neuralgia (PHN). We describe health utilities, health care resource utilization (HCRU), productivity loss and health care costs in recipients of autologous hematopoietic stem cell transplantation (Auto-HSCT) who developed confirmed HZ in the phase 3 clinical trial.

METHODS: HCRU, costs, and EQ-5D-3L utility were assessed for 155 confirmed HZ cases observed after receiving inactivated varicella zoster virus (VZV) vaccine (ZVIN ) or placebo. In a prospective, longitudinal 6-month follow up, costs and utilities were analyzed for two health states, HZ without PHN and HZ with PHN.

RESULTS: There was a clinically relevant difference in utility between HZ without PHN (mean 0.814) and HZ with PHN (0.729). The disutility for HZ without PHN was estimated to -0.117 and to -0.186 for HZ with PHN. Direct costs (2017 USD) associated with a HZ without PHN episode and HZ with PHN episode was estimated at $3,412 and $3,711, respectively, of which hospitalizations accounted for 90% of costs.

CONCLUSION: Both HZ and PHN are associated with considerable disutility in recipients of auto-HSCT. Costs were comparable to published estimates in other immunocompromised subjects.The trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT01229267).